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Indian Journal of Pharmacology, Vol. 38, No. 1, January-February, 2006, pp. 79-80 Web-Wise Clinical Trial Results Singh J Department of Pharmacology, JIPMER, Pondicherry - 605006 Code Number: ph06021 [Figure 1] Cardiovascular diseases have become the commonest cause of morbidity in the modern world. The affluent as well as developing nations are increasingly realising the need for meeting treatment challenges posed by an array of cardiac and related problems. Much has changed in the modalities for treating these disorders in the past decade mainly because of the adaptation of a systematic evidence-based approach coupled with well planned long-term clinical trials. Globalisation of policy and the international nature of these trials have ushered in an era where co-operation and collaboration have been encouraged in the context of providing cost-effective services. Treatments are now not only limited to interventional methods. Pharmacotherapeutic options are available that significantly improve symptoms and quality of life especially in older patients who would previously have been considered as too high a risk for surgical interventions. The last two decades have witnessed the emergence of a large number of clinical trials performed and published under a variety of acronyms and variants. It requires effort to sift relevant information from this confounding multiplicity of names. The website ClinicalTrialResults.org is from an organization of clinical trial researchers headed by Dr. C. Michael Gibson whose goal is, "to rapidly disseminate emerging clinical trial results to physicians and other health care professionals so that they in turn can educate their colleagues and patients with the ultimate goal of accelerating the delivery of newer treatments". The overall emphasis of the website is on cardiovascular topics, mainly in the form of downloadable PowerPoint presentations. This mode of delivery promises to be more direct and less time consuming than either readable text or audio presentations. Most of the information is designed to be just one click away from the website for ease of location, but this method compromises easy navigability that is sometimes essential. The website is divided into tabbed pages that contain the resource slides. The pathophysiology link leads on to presentations on stroke, atherosclerosis and myocardial perfusion. Another website, theblush.org also authored by Dr. Gibson is linked for learning resources associated with perfusion and Thrombolysis in Myocardial Infarction (TIMI) reports and slides. (Details of TIMI can also be found on TIMI.org, another website maintained by the same author). The Acute Coronary Syndrome (ACS) page consists of a number of resources especially related to ST Elevation Myocardial Infarction (STEMI), non-STEMI and stable angina. A number of trials that have used pharmacological interventions are mentioned in the sub-topics. Notable trials that have used Platelet GPIIb/IIIa receptor blockers, www.clinicaltrialresults.org Matrix Metalloproteinase Inhibitor, beta-adrenergic blockers, low molecular weight heparins, clopidogrel and other thrombolytics are mentioned. Outcomes of the use of medicines in combination with Percutaneous Coronary Intervention (PCI) and other procedures are also detailed in various clinical trials mentioned on this page. There is a separate page on PCI which contains details of Device Trials and Restenosis, trials of drug eluting stents and related devices and some pharmacotherapeutic agents (clopidogrel, pioglitazone). The Lipids page goes on to describe guidelines (NCEP-ATP-III), meta-analysis on the use of lipid lowering agents and slides detailing lipid metabolism. Study design and results of recent multicentric trials (4S, ALLHAT); smoking cessation (STRATUS-US); Obesity (RIO Europe, RIO Lipids); diabetes (PROACTIVE, UKPDS) can be found on this page. The Congestive Heart Failure (CHF) section contains an overview of the epidemiology, trials with ACE inhibitors, calcium channel blockers, beta adrenergic blockers and some other agents. The use of mechanical intervention studies also figure on the page. The Hypertension page, surprisingly is the least informative. It only features the ALLHAT trial and the JNC guidelines for hypertension. The page for Electrophysiology lists some of the trials and results carried out for different arrhythmias and the Peripheral Vascular Disease page lists the LIMB trial in which buflomedil has been used for its first large trial. The website contains a wealth of up-to-date material and forms a useful source of educational material for teaching, understanding different clinical trials, designs, their nomenclature, and as a valuable starting point for future ideas for clinical research in cardiology[Figure - 1]. Copyright 2006 - Indian Journal of Pharmacology The following images related to this document are available:Photo images[ph06021f1.jpg] |
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